ICU Diaries and Post-ICU Distress Symptoms

ICU Diaries and Post-ICU Distress Symptoms
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In recent years, health diaries have become an important tool for patients and providers to manage personal health. A health diary is a record of a patient's overall health and wellness, which the patient writes to keep track of different aspects of their health. Studies show that greater self-care behaviours, such as the use of symptom diaries, improve survival for patients with heart failure. Health diaries, either in written or electronic format, are an effective way to ensure proper treatment administration and promote treatment adherence. A health diary is also valuable for monitoring patient-reported outcomes in daily clinical practice. 

Health diaries also increase awareness of personal health-related issues. In particular, ICU diaries help patients with post-ICU distress symptoms. ICU diaries are commonly used to communicate with patients and family members about the patient's ongoing progress and any specific issues related to the patient's condition or care plan. 

Brandao Barreto et al. (2022) provide evidence that health diaries, used with mechanically ventilated patients in an ICU for over 24 hours, may show positive health benefits for preventing psychiatric symptoms after critical illness. The diaries were written by family members and ICU staff. Diary entries were open-ended and could include factual accounts and pictures of what occurred with the patient medically or with staff and family members while the patient was sedated and on the ventilator. Patients could also write in the diary after three days off the ventilator. 

The goal of ICU diaries is to provide patients with a factual account of their ICU stay so that they could fill in memory gaps and better understand what occurred during their critical illness and how they survived. ICU-related post-traumatic stress disorder (PTSD) has been shown to be associated with delusional memories by the patient. Using an ICU diary can provide the patient with factual information, which could help reduce PTSD. Photographs in the diaries are also a source of support for the patient and family members and effective in preventing psychologic symptoms post-ICU. ICU diaries are thus important for the psychological well-being of patients. They can help reduce the risks of depression and preserve the quality of life of patients after ICU admission. 

It is important to note that the time pressure of staff members in the ICU could prove to be an obstacle for staff diary entries. Researchers suggest quality improvement strategies to improve the data entered into these diaries. These include the need to standardise the ICU diary process, the use of nurses to facilitate the diaries, make entrees, and take photographs while considering the nurses' workload and financial support for the diary process. The study authors also highlight the need for diary follow-up appointments with patients and family members to evaluate the general diary process and assess the overall experience with patients and family members. 

Image Credit: iStock 

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References:

Anderson-Shaw LK (2022) ICU Diaries: A Useful Tool in the Reduction of Psychiatric Symptoms After Critical Illness. Critical Care Medicine. 50(11):1685-1687. 

Barreto BB, Luz M, Gusmao-Flores D (2022) Using Qualitative Synthesis to Explore Heterogeneity of Randomized Trials on ICU Diaries. Critical Care Medicine. 50(11):1654-1661. 

Published on : Wed, 9 Nov 2022



ICU, critical illness, post-ICU, psychiatric symptoms, ICU dairies ICU Diaries and Post-ICU Distress Symptoms

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